CNIH - Dental Hygiene Program2012

Revised March 2012

CANADIAN NATIONAL INSTITUTE OF HEALTH

Dental Hygiene Program

Spring 2012

CLINICAL MANUAL

Appendix for Academic Level 02

Course DH 280

REQUIREMENTS FORCLINICAL PRACTICE I DH 280

Attendance

Attendance at all clinical sessions is mandatory. In cases of illness or emergency, contact the clinical coordinator by e-mail at dcall the college clinical reception (613-726-2644)at least one hour before the session. This number provides 24-hour access to the voice mail system.Verification of the reason for your absence (a doctor’s note or other appropriate information) will be required upon your return to school. You may be required to make up time lost.

Unsubstantiated absence from 3 or more sessionsduring the term will result in failure of course DH 280, Clinical Practice I.

Clinical Skills Evaluation

During all sessions assessment will be done according to a criterion-referenced system of skill evaluation. The criteria for all of the skills making up the course are listed in Section III of the Clinical Manual. When formal assessments are recorded, each skill will be designated as “pass” (acceptable) or “fail” (unacceptable). To be successful in a skill, all components designated as “critical” must be performed at an acceptable level. Critical elements are in bold type and are the critical standards for the practice of dental hygiene by the students of dental hygiene in all circumstances. Standards written in plain type are those standards of professional conduct to which the student of dental hygiene should aspire, in the context of the practice environment, the client’s participation in the decision-making process and the student of dental hygiene’s experience.

A perfect record in skill performance is not expected. Competence is expected a majority of times the skill is performed or the service provided. The performance record is calculated by dividing the number of times a skill has been performed acceptably in graded attemptsby the total number of times that skill has been evaluated for a grade.

Since CNIHuses a learning outcomes system of evaluation, every skill required in every clinical course is considered equally important. Therefore, in order to pass a clinical course, every skill must be demonstrated at an acceptable level of competence. The level of competence required for each skill is expressed as a percentage calculated using thesuccessful attempts/total number of tries ratio.

The table below lists the skills to be accomplished in Academic Level 02 in DH 280 Clinical Practice. The columns are defined as follows:

Skill

– lists all of the clinical skills that are considered to be part of the DH 280 course.

Minimum number of tries

– indicates the number of formal graded assessments for each skill that must be completedin order to compute the final grade.

Revised March 3, 2010

ASSESSMENT OF SKILLS and/or PROCEDURES IN CLINICAL SESSIONS

Students request a skill and/or procedure assessment by placing their name and treatment unit number on the board in the dental clinic under the name of the clinical instructor who will perform the evaluation. The instructor will attend to students as soon as possible. Please be patient, each student and client deserves careful attention from the instructors. All requests for evaluation of skill and/or procedure must be placed on the white board 60 minutes before the end of a clinical session

Mandatory Completion of Care for Clients (Level 02):

Level 02 students must complete care for 1peer-client prior to advancing to the provision of dental hygiene care for clients from the general public. Once students have received formative evaluation of therapeutic skills for 1 peer-client they may advance to the provision of dental hygiene care for clients of the CNIH Inc. Dental Hygiene Clinic. Given the formative nature of the evaluation process, the care provided for the peer-client, may not be considered towards the total number of completed clients required for successful completion of DH280 Clinical Practice I.

Once the peer-client formative evaluation process has been successfully completed, level 02 students must complete care for a minimum of8clientsin the CNIH Inc. Dental Hygiene Clinic over the course of the academic term as part of the requirement for successful completion of DH280 Clinical Practice I. Upon completion of care the student receives credit for a completion. Two of the 10 completed clients must be “case presentations” for which the student has achieved a grade of “Passed” (Clinical Manual – Section III - Clinical Assessment Performance Criteria). Students are initiated to the role of primary oral health care provider in this supervised clinical setting. The delivery of dental hygiene services requires the supervised students work with their clients to assess their oral health needs, select and implement the most appropriate services and evaluate outcomes. Students demonstrate,through the application of the Dental Hygiene Unmet Human Needs theory, the dental hygiene process of care, problem solving and critical thinking in the clinical setting.

The level 02 students provide care to members of the general public who require simple to moderately difficult treatment protocols for the attainment and maintenance of oral health.

In addition students must complete Duty Student Assignments as part of their clinical competencies.

Required Care for a peer:

Students are provided with the opportunity to demonstrate respectful practice through the application of clinical skills and reasoning to a peer prior to advancing to care for clients from the general public. Students are supported in their learning through formative evaluation.

Prior to advancing to care for members of the general public students must receive formative evaluation for the following skill categories:

Skill / Minimum number of completions of skill.
Case decision & Self Assessment / 0*
Care of client tissues / 2
Client/operator positions / 2
Client education/OHI / 0*
Deposit detection / 1
Deposit removal / 1
Document management / 0*
Exam – dental / 1
Exam – extra-oral / 1
Exam – health history / 1
Exam – indices / 1
Exam – intra-oral / 1
Exam – occlusal / 1
Exam – periodontal / 1
Instrument– activation / 1
Instrument– adaptation / 1
Instrument – fulcra / 1
Instrument – grasp / 1
Instrument – insertion / 1
Instrument – sharpening / 1
Impressions / 1Max/1Mand
Operating field maintenance / 1
Professional conduct / 0*
Time Management / 0*
Vital signs (blood pressure) / 1
Work Habits / 0*

Note: Skills designated * are evaluated at random intervals at the supervising clinician’s discretion

Revised March, 2012

Required Completed Clients and Categories (Level 02):

Please note that clients who do not present with a minimum level of difficulty of at least DD1 cannot be counted towards satisfying client completion requirements.

Category / Minimum total number required (including case presentations)
Adult minimal without periodontal involvement established at a level of difficulty of DD1-DD2 / 1 Case presentation
And
4 Completed Clients
Periodontal clients with a minimum level of difficulty of DD3-DD4 / 0 Case presentations
1 Completed Clients
Child (4-17 years of age) / 1 Case presentation
And
1 Completed Client
Minimum total number of clients / 8

Note: Professional development skills are defined (with a list of some examples) in Section III of the clinical manual.

Maintaining a pass to tries ratio less than the set minimum in this category can result in failure of a clinical course. Promotion to the next academic level will be determined by the Academic Advancement Committee. (Refer to due process policy in the student handbook)

Required completion of skills for DH280 Clinical Practice I

Please note: Required pass to tries ratio pass to tries ratio

– states the percent that must be obtained for a pass grade in the skill. It is computed by dividing the number of successful graded attempts at the skill by the total number of graded attempts for the skill.

Grade Computation for Skills Categories Clinical Practice I, DH 280

Skill / Minimum number of tries.
When set at 0 a grade may be assigned at every attempt of the skill. / Except where noted, required pass to tries ratio in the skill is 70%
Case decision & Self Assessment / 0**
Care plan / 8
Care of client tissues / 0** / 90%
Client/operator positions / 5*
Client education / 5
Coronal polish / 6
Deposit detection / 6
Deposit removal / 12
Document management / 0** / 90%
Enamel sealants / 4 teeth
Exam – dental / 0
Exam – extra-oral / 5 passed observations
Exam – health history / 0
Exam – indices / 0
Exam – intra-oral / 0
Exam – occlusal / 0
Exam – periodontal / 6
Fluoride application / 5
Impressions (alginate) / 1max/1mand
Instrument– activation / 5*
Instrument– adaptation / 5*
Instrument – fulcra / 5*
Instrument – grasp / 5*
Instrument – insertion / 5*
Instrument – sharpening / 3*
Mouth guard/bleaching tray / 1 set bleaching trays
Nutrition counselling / 1
Operating field maintenance / 5*
Professional conduct / 0** / 90%
Radiographs / 10 individual views & FMS
Time Management / 0** / 90%
Ultrasonic technique / 2
Vital signs (blood pressure) / 2 passed observations
Work Habits / 0** / 90%

Note: Skills designated * are evaluated at random intervals at the supervising clinician’s discretion and are to be completed prior to the midterm of the session.

Skills designated ** are evaluated at random intervals at the supervising clinician’s discretion

FMS must include a minimum of 12 radiographs.

To complete this course successfully, the required percentage must be obtained for each and every skill listed above. At the discretion of the Academic Advancement Committee, students not failing more than three (3)competencies in a clinical coursemay be granted supplemental privileges in the course.

Duty Student Requirement

Students must receive a passing grade in all categories to fulfil the Duty Student Requirement. Students are required to demonstrate application of Duty Student Assignment skills until the requirement has been satisfied.

Duty Student Assignment Log / Record of Date for Completion of Assigned Task
Mm/dd/yy / Grade
Pass/
Fail / Remediation of Task
Date
Mm/dd/yy / Remediation
Grade
Pass/Fail / Instructor Signature
Dispensary
Dispensing of equipment and sundries throughout the clinic session
Confirm receipt of signed out equipment
Confirm all received equipment is intact
Application of asepsis for all areas of equipment processing
Loading and running of Statim autoclave including filling and emptying of water
Loading and running of Tuttnauer autoclave including filling of water
Record keeping for sterilizer usage
Inspection,packaging and sterilizing of cavitron ultrasonic tips
Inspection, lubrication, packaging and labelling of slowspeed handpieces.
Identification, labelling and sterilizing of instrument cassettes
Cleaning,packaging and sterilizing of impression trays
Sealant Kit-inspection and replenishing of materials

Professional Misconduct Penalties

In addition to clinical competence, dental hygiene practitioners are expected to display professional conduct in all circumstances, whether in the classroom, the laboratory, the dental hygiene clinic or during off site learning activities. Professionalism in the approach to clinical services should be developed from the start.

Faculty or school staff members who observe students behaving unprofessionally or in a manner that compromises operator or client safety can assign a clinical penalty. The table below defines how accumulation of penalties will affect the final grade in DH280 Clinical Practice I.

Maximum number of penalties allowed

Category / Maximum # of professional misconducts allowed per category
Documents management / 2
Work habits / 2
Professional conduct / 2
Time mismanagement / 2
Total number of professional penalties allowed (across any combination of subject areas) / 3

Note:Professional misconduct is defined (with a list of some examples) in Section III of the clinical manual.

Accumulation of more than the maximum number of penalties in any one of the categories listed above, or the accumulation of more than the maximum total number of penaltiesacross a combination of categories results in failure ofDH 280 Clinical Practice I. Promotion to the next academic level will be determined by the Academic Advancement Committee. (Refer to due process policy in the student handbook)

Revised March, 2012

PROMOTION POLICY

At the end of the term, if failing grades are recorded in any skill, an overall grade of “fail” will be assigned to course DH 280Clinical Practice I.

At the end of each term, all students’ grades in all courses are reviewed by the Academic Advancement Committee (AAC). This group reviews the academic progress of all students in the program and advises each student of his/her status in the program.

The AAC may make any of the following decisions:

-Student is promoted to the next academic level.

-Supplemental privilege(s) is/are appropriate. Supplemental privileges are not automatically granted and will be limited in number.

-Overall performance in the program indicates that the student will be required to repeat the entire academic level.If the student decides on this course of action, s/he will be admitted into the program on a space available basis. Appropriate fees will be charged for this privilege.

-Overall performance in the term is so poor that the student is required to withdraw from the program and if s/he wishes to be admitted must complete the admissions process and compete with other applicants for admission.

Each student in the program will receive a progress report (report card) within 10 working days of the end of each academic term.

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Clinical Manual – Appendix: Academic Level 02